Individual provider Active NPI

Daniel Kim Frum, M.D.

  • Dermatology Physician
  • Silverdale, WA
National Provider Identifier
1194775619
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD00022155 Issued in WA
Practice address
2011 NW Myhre PL
Silverdale, WA 98383-8561
Phone
(360) 830-1701
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD00022155 WA Primary

Addresses

Primary practice location

2011 NW Myhre PL
Silverdale, WA 98383-8561

Mailing address

9621 Ridgetop Blvd NW
Silverdale, WA 98383-8502
Phone (360) 830-1701

Other practice location 1

9621 Ridgetop Blvd NW
Silverdale, WA 98383-8502
Phone (360) 782-3400

Other identifiers 6

IdentifierTypeStateIssuer
104716OtherWALABOR & INDUSTRIES
8931440OtherWACRIME VICTIMS COMP
5899059OtherAETNA
FR9546OtherREGENCE BLUESHIELD
070008998OtherRAILROAD MEDICARE
8186256MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1194775619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9621 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838502",
            "telephone_number": "360-830-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 NW MYHRE PL",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838561",
            "telephone_number": "360-830-1701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9621 Ridgetop Blvd NW",
            "address_purpose": "LOCATION",
            "city": "Silverdale",
            "state": "WA",
            "postal_code": "983838502",
            "country_code": "US",
            "telephone_number": "360-782-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRUM",
        "first_name": "DANIEL",
        "middle_name": "KIM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00022155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "104716",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS COMP",
            "identifier": "8931440",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5899059",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "FR9546",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070008998",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8186256",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.